✅ Major Changes Coming to Marketplace Health Insurance in 2026

If you buy your health insurance through the Marketplace (Healthcare.gov), there are some major changes coming to Marketplace Health Insurance in 2026 that could affect your monthly premiums and financial assistance.

At Couvillier Advisors, we want to make sure you stay informed, stay covered, and avoid unexpected costs. Here’s what you need to know about the 2026 Marketplace Health Insurance changes that are coming.

💸 Tax Credits Are Changing — and Premiums May Go Up

During the COVID-19 pandemic, the federal government passed temporary laws to increase tax credits (also called subsidies) that helped lower monthly health insurance costs for millions of Americans.

These enhanced tax credits are set to expire at the end of 2025, which means:

• You may receive less financial help in 2026

• Your monthly premium may increase, even if your income stays the same

• Fewer people may qualify for full or partial financial support

✅ If you’ve been paying a lower premium in recent years, now is the time to plan ahead.

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🧾 Income Verification Will Be Required

To qualify for any financial help in 2026, you’ll be required to verify your household income during the Open Enrollment Period.

You may be asked to upload:

• Recent pay stubs

• A tax return

• Social Security or unemployment benefit letters

• Other official income documents

📌 If you don’t complete this step, your premium could increase by $5/month or more — or you could lose your financial help altogether.

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📅 Open Enrollment Dates You Need to Know

To keep your financial support and health coverage, you must renew or update your application between:

🗓 November 1 – December 15, 2025

If you miss this window, you may have to wait until the next year — unless you experience a qualifying life event like a job loss or birth of a child.

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🚫 Other 2026 Rule Changes That Could Affect You

🚫 No More Monthly Plan Changes for Some Low-Income Households

If your income is at or below 150% of the Federal Poverty Level (FPL), you’ll no longer be able to switch Marketplace plans monthly. You'll need to:

• Enroll or renew during Open Enrollment, OR

• Qualify for a Special Enrollment Period (SEP)

✅ This change does not apply to members of federally recognized tribes.

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⚠️ Stricter Rules for Proving Income

• If your income doesn't match federal records, you’ll be asked to submit more documentation

• If the IRS doesn’t have tax data for you, you must submit other documents — you can’t just self-report

• The automatic 60-day extension to resolve document issues is being removed. You’ll have 90 days, but must ask for more time if needed.

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🙅‍♂️ DACA Recipients Still Ineligible for Marketplace Coverage

If you have DACA status (Deferred Action for Childhood Arrivals), you are still not considered "lawfully present" and remain ineligible for:

• Marketplace health plans

• Tax credits or cost-sharing help

• Basic Health Program coverage

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✅ What You Can Do Now

✔️ Start gathering your income documents early

✔️ Mark your calendar for November 1, 2025

✔️ Watch for official notices from Healthcare.gov

✔️ Reach out to your advisor with questions — we’re here to help!

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📚 Stay Updated

We’ll continue to post updates, tips, and reminders on our Insights page as we get closer to Open Enrollment.

Your health coverage matters — and we’re here to help make this transition smooth, affordable, and stress-free.